The association between AHA CPR quality guideline compliance and clinical outcomes from out-of-hospital cardiac arrest

Cheskes, Sheldon; Schmicker, Robert H.; Rea, Tom; Morrison, Laurie J.; Grunau, Brian; Drennan, Ian R.; Leroux, Brian G.; Vaillancourt, Christian; Schmidt, Terri A.; Koller, Allison C; Kudenchuk, Peter J.; Aufderheide, Tom P.; Herren, Heather; Flickinger, Katharyn L; Charleston, Mark; Straight, Ron; Christenson, Jim

doi:10.1016/j.resuscitation.2017.05.003

Cited by 50 publications

(42 citation statements)

References 33 publications

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“…Current best practice CPR in both human and veterinary medicine is derived from evidence- and consensus-based treatment recommendations and CPR is generally considered excellent when it complies with these guidelines (10, 22). Implementation of CPR guidelines in people led to improved outcomes (23–25). To improve health care system-wide outcomes from CPA, leaders in the human resuscitation community developed a formula for survival that includes the domains of medical science, educational efficiency and local implementation.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, a common, authoritative standard such as the RECOVER guidelines were not yet available at that time. In human medicine, deviations from recommended CPR techniques were found to be highly prevalent and more recently, analysis of defibrillator recordings of various chest compression quality metrics provided good insight into actual clinical CPR performance (23, 27–29). One study analyzing data from an international registry with 19,568 out-of-hospital CPA cases with full CPR quality data available, found that only 15% of patients were treated with guideline-compliant CPR (23).…”

Section: Discussionmentioning

confidence: 99%

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The Compliance of Current Small Animal CPR Practice With RECOVER Guidelines: An Internet-Based Survey

et al. 2019

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In 2012 the Reassessment Campaign on Veterinary Resuscitation (RECOVER) published evidence-based treatment recommendations for dogs and cats with cardiopulmonary arrest (CPA), to optimize the clinical practice of small animal CPR and positively impact outcomes. Six years after the release of these guidelines, we aimed to determine the compliance of small animal veterinary CPR practices with these RECOVER guidelines. To identify current CPR practices in clinically active small animal veterinarians and their awareness of the RECOVER guidelines, we conducted an internet-based survey. Survey invitations were disseminated internationally via veterinary professional organizations and their social media outlets. Questions explored respondent demographics, CPR preparedness, BLS and ALS techniques and awareness of RECOVER guidelines. Responding small animal veterinarians ( n = 770) in clinical practice were grouped by level of expertise: board-certified specialists (BCS, n = 216) and residents (RES, n = 69) in anesthesia or emergency and critical care, practitioners in emergency (GPE, n = 299) or general practice (GPG, n = 186). Large disparities in preparedness measures, BLS and ALS techniques emerged among levels of expertise. Only 32% (95% CI: 29–36%) of respondents complied with BLS practice guidelines, varying from 49% (95% CI: 42–55%) of BCS to 15% (95% CI: 10–20%) of GPG. While incompliances in BCS, RES, and GPE were predominantly due to knowledge gaps, GPG compliance was further compromised by limitations in the resuscitation environment (e.g., defibrillator availability, team size). Those aware of RECOVER guidelines (100% of BCS and RES; 77% of GPE; 35% of GPG) were more likely to comply with recommended preparedness (OR = 2.4; 95% CI: 1.2–4.8), BLS (OR = 4.5; 95% CI: 2.4–9.1), and ALS techniques (OR = 7.8; 95% CI: 2.4–9.1) independent of age, gender, region of practice or level of expertise. We conclude that awareness of RECOVER guidelines is high in specialists and residents, but incomplete among general practitioners. This awareness positively influenced compliance with CPR guidelines, but CPR practices continue to be variable and largely not in agreement with guidelines. A widely accessible educational strategy is required to broadly improve compliance with best practices in small animal CPR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Compliance of Current Small Animal CPR Practice With RECOVER Guidelines: An Internet-Based Survey

et al. 2019

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“…The outcome of out-of-hospital cardiac arrest (OHCA) is significantly, positively, and independently correlated with the suitability for different CCF targets, CC frequency, CC depth, and brief predefibrillation pause (< 10 s) [17,18]. Mechanical CC devices have not proven their superiority over manual CC [19], and manual CC remains the gold standard.…”

Section: Introductionmentioning

confidence: 99%

Impacts of chest compression cycle length and real-time feedback with a CPRmeter® on chest compression quality in out-of-hospital cardiac arrest: study protocol for a multicenter randomized controlled factorial plan trial

Buléon

Parienti

Morilland-Lecoq

et al. 2020

Trials

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Background: With a survival rate of 6 to 11%, out-of-hospital cardiac arrest (OHCA) remains a healthcare challenge with room for improvement in morbidity and mortality. The guidelines emphasize the highest possible quality of cardiopulmonary resuscitation (CPR) and chest compressions (CC). It is essential to minimize CC interruptions, and therefore increase the chest compression fraction (CCF), as this is an independent factor for survival. Survival is significantly and positively correlated with the suitability of CCF targets, CC frequency, CC depth, and brief predefibrillation pause. CC guidance improves adherence to recommendations and allows closer alignment with the CC objectives. The possibility of improving CCF by lengthening the time between two CC relays and the effect of real-time feedback on the quality of the CC must be investigated.

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“…Advanced life support (ALS) simulation training is a prerequisite for medical staff in critical care specialties [ 1 ]. American Heart Association simulation-based ALS courses teach fundamental resuscitation methods for cardiac arrest with a variety of clinical features and dysrhythmias [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Problem-based learning for anesthesia resident operating room crisis management training

2018

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BackgroundSenior anesthesia residents must acquire competency in crisis management for operating room (OR) emergencies. We conducted problem based learning (PBL) OR emergency scenarios for anesthesia residents, focused on emergencies in ‘Airway’, ‘Circulation’, ‘Central venous catheter’, and ‘Pain management complications’. Non-technical skills are an integral component of team-based OR emergency management.MethodsPrior to integrated OR emergency clinical and non-technical skills PBL training, participating 35 anesthesia residents completed two 5-point scale surveys regarding frequency of emergency experiences in the operating room, and self-confidence for anesthesia-related crisis management. Repeat administration of the self-confidence survey was completed immediately following PBL training.ResultsPost-PBL resident clinical management self- confidence improved (P<0.05) in all scenarios on Circulation, Central venous catheter, and Pain treatment related complication topics. Impossible intubation, impossible oxygenation, and awake intubation did not show significant difference following PBL.ConclusionOur findings suggest that PBL for OR emergency management can improve resident self- confidence in anesthesia residents.

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The association between AHA CPR quality guideline compliance and clinical outcomes from out-of-hospital cardiac arrest

Cited by 50 publications

References 33 publications

The Compliance of Current Small Animal CPR Practice With RECOVER Guidelines: An Internet-Based Survey

The Compliance of Current Small Animal CPR Practice With RECOVER Guidelines: An Internet-Based Survey

Impacts of chest compression cycle length and real-time feedback with a CPRmeter® on chest compression quality in out-of-hospital cardiac arrest: study protocol for a multicenter randomized controlled factorial plan trial

Problem-based learning for anesthesia resident operating room crisis management training

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